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日本急性中风患者性别分层分析中酒精摄入量与缺血性中风严重程度的关系

Relationships between Alcohol Intake and Ischemic Stroke Severity in Sex Stratified Analysis for Japanese Acute Stroke Patients.

作者信息

Shiotsuki Hiroyuki, Saijo Yasuaki, Ogushi Yoichi, Kobayashi Shotai

机构信息

Department of Social Medicine, Asahikawa Medical University, Hokkaido, Japan.

Ogushi Institute of Medical Informatics, Kanagawa, Japan.

出版信息

J Stroke Cerebrovasc Dis. 2019 Jun;28(6):1604-1617. doi: 10.1016/j.jstrokecerebrovasdis.2019.02.034. Epub 2019 Mar 21.

Abstract

BACKGROUND

The aim of this study is to evaluate in the relationships between alcohol intake and ischemic stroke severity in Japanese stroke patients.

METHODS

Of a total of 101,165 registered cases of stroke in Japan, patient data of total strokes (n = 60,836), cardiogenic strokes (n = 11,894), and noncardiogenic strokes (n = 29,129) were extracted. The National Institutes of Health Stroke Scale (NIHSS) score at admission and the modified Rankin Scale (mRS) score at discharge were used. Significant alcohol consumption in regard to stroke severity at admission and discharge was identified by multivariate adjusted logistic regression analysis.

RESULTS

Among all subject and males, nondrinkers had significantly poorer NIHSS scores of cardiogenic strokes as did those consuming greater than or equal to 60 g/day, whereas there was a significant difference in past heavy drinkers with noncardiogenic strokes. Among females, nondrinkers had a significance of cardiogenic stroke and non-cardiogenic strokes. Among all subjects and males, 20-39 g/day and 40-59 g/day were significantly associated with protective effects on mRS severity of cardiogenic strokes, whereas 40-59 g/day also had significant protective effects for noncardiogenic strokes. Among females, greater than or equal to 60 g/day had a significant protective effect for cardiogenic strokes.

CONCLUSIONS

For males, alcohol intake of less than 60 g/day played a protective role in functional prognosis at discharge and showed a J-shape relationship. For females, although there was a limitation that the number of female drinkers was small, negative effects were shown at admission with less consumption than males.

摘要

背景

本研究旨在评估日本中风患者酒精摄入量与缺血性中风严重程度之间的关系。

方法

在日本登记的总共101,165例中风病例中,提取了全部中风(n = 60,836)、心源性中风(n = 11,894)和非心源性中风(n = 29,129)的患者数据。使用入院时的美国国立卫生研究院卒中量表(NIHSS)评分和出院时的改良Rankin量表(mRS)评分。通过多变量调整逻辑回归分析确定入院和出院时与中风严重程度相关的显著酒精摄入量。

结果

在所有受试者和男性中,不饮酒者的心源性中风NIHSS评分显著低于每天饮酒量大于或等于60克的人,而过去大量饮酒者与非心源性中风存在显著差异。在女性中,不饮酒者在心源性中风和非心源性中风方面存在显著差异。在所有受试者和男性中,每天20 - 39克和40 - 59克与心源性中风mRS严重程度的保护作用显著相关,而每天40 - 59克对非心源性中风也有显著保护作用。在女性中,每天饮酒量大于或等于60克对心源性中风有显著保护作用。

结论

对于男性,每天饮酒量小于60克对出院时的功能预后起保护作用,并呈J形关系。对于女性,尽管女性饮酒者数量较少存在局限性,但入院时饮酒量低于男性时显示出负面影响。

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